Myocardial ischemia is the reduction of blood flow to cardiac tissue which can result in cell death (infarction) and dysrhythmic conditions, e.g. ventricular arrhythmia and ventricular fibrillation.
Certain calcium channel blockers and thromboxane receptor antagonists have been identified as anti-ischemic agents by their ability to reduce infarct size. Many calcium antagonists also possess cardiodepressant activity, i.e. they reduce contractile function. This is of importance since cardiodepression in patients with coronary insufficiency may further compromise hearts possessing low functional reserve. Accordingly, certain calcium channel blockers are contraindicated in patients with poor myocardial function.
In an effort to optimize treatment for patients with ischemic heart disease, anti-ischemic agents can be evaluated in terms of an ischemic selectivity which can be viewed as a ratio of cardioprotection to cardiodepression. Anti-ischemic agents which provide a satisfactory level of cardioprotection with minimal cardiodepression would be a useful addition to the art.